@sarahlee2 oh no! I’m so sorry! I’m just wondering out loud … since you tested positive for latent TB, whether IVIg might be a safer alternative to get you started on treatment right now. I don’t think there’s a contraindication as it doesn’t lower your immunity (if anything, you’re gaining everyone else’s immunity). Here, it’s often the path that the insurance companies will make you start with a less expensive treatment before they’ll cover you for a mostly costly one. Many start with MTX, then Rituxan, and then eventually wind up on IVIg, but who knows - having latent TB might be one way you can by-pass all that. I would certainly ask!